Clinic Information and Health Forms

  • School Nurse:   Donna Gaul, RN  
    Phone Number:  540-786-4400, extension 6019
    Fax Number:  540-786-7109 
    Email:  dgaul@spotsylvania.k12.va.us
     
    Use this link to access all health services forms.   
     
    Tdap:  Rising 6th graders MUST have the Tdap before beginning middle school.  
     
     
    Fever/Vomiting:
    Spotsylvania County Schools advise that all students be fever free (<100 degrees) without the benefit of fever reducing medication and/or without vomiting for 24 hours prior to returning to school to avoid cross contamination of an illness within the student population.  
     
     
    Medicine:
    All medication, over the counter and/or prescribed medication may be administered by the school nurse or Principal/Designee.  In order for any medication to be given to your student at school, your physician must complete and sign the Medication Request Form.  Parents must also sign the statement at the bottom of the form.  Medication will not be given unless this form is completed and returned to the school nurse clinic.  Please hand-deliver all medication to the school as Spotsylvania County Schools does not allow transport of medication within the student's backpack without prior approval from the physician.  This form must be renewed with each school year.  
     
     
     
    Food Allergy:
    Does your student have a known food allergy?  The following information needs to be completed each school year by your physician and returned to the school nurse clinic.  
     
     
     
     
    Asthma:
    Does your student have Asthma/Reactive Airway Disease?  The following information needs to be completed each school year by your physician and returned to the school nurse clinic.

    VA Asthma Action Plan Form
     
     
    Communicable Disease & Conditions:
    Please inform the school if your student has been diagnosed with a suspected communicable disease, which includes but is not limited to ringworm, impetigo, head lice, conjunctivitis (pink eye), chicken pox, scarlet fever/strep throat, pertussis, and meningitis.  Other diseases not listed are located on the Virginia Department of Health's Communicable Disease Reference Chart for School Personnel.   
     
     
    Head Lice: 
    Spotsylvania County Schools has a "No Nit Policy."  A student may be readmitted to school once proof of the treatment for lice infestation has been verified and the school nurse has checked the student to determine that they are nit and lice free.